A swing from the hips extends the shelf life
Dr. Stefan Schmidl, Consultant at the Centre for Joint Replacement, explains why exercise is important even with an artificial joint.
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Everyone knows the saying: ‘A rolling stone gathers no moss.’ But is there really any truth to this cliché? As a specialist in joint replacement surgery, Dr Stefan Schmidl knows exactly how important activity is for the joints. And he confirms: Exercise is absolutely essential for both natural and artificial joints. A joint is designed to be moved. However, it is important that this is always appropriate for the individual patient. “Exercise is generally important for muscles, joints and the cardiovascular system. Even before an operation, the muscles should be exercised to maintain stability in the joint. This stabilisation prevents discomfort and makes the post-operative period easier,” he explains.
Studies show that appropriate exercise can actually prolong the life of a prosthesis more effectively than complete rest. The reason for this is that exercise strengthens the muscles, which in turn provide stability within the joint. However, the knee and hip differ in terms of the stresses they endure. While the hip joint is a relatively simple ball-and-socket joint that can move freely in all directions — within the permitted range of motion — the knee joint is significantly more complex. In addition to flexion and extension, complex rolling, sliding, and rotational movements occur in every conceivable combination. Furthermore, the soft tissue envelope is significantly thinner, and there is a tight network of ligaments that influence the entire range of motion.
“During individual follow-up consultations, we determine which sports are appropriate and when it’s safe to resume them.”
Dr. Stefan Schmidl
Chief of Endoprosthetics
Stress on the Prosthesis
During sports, hip and knee prostheses are subjected to forces that are many times the body weight. For example:
- Walking: 2.5–5 times body weight on the hip prosthesis
- Jogging: 7 times body weight
- Skiing: up to 8 times body weight
Individual follow-up consultations will determine which sports are appropriate and when it is safe to resume them. Pain or swelling are warning signs and should be evaluated by a doctor.
Strong muscles provide support fot the joint
These findings have led to the practice of beginning patient mobilization on the day of surgery. “Patients typically get out of bed on the day of surgery under the guidance of a physical therapist. The goal of this measure is to maintain joint mobility, prevent adhesions and scarring, stimulate circulation, and thereby prevent potential postoperative complications — such as thrombosis, embolism, or pneumonia. Furthermore, early mobilization contributes to reduced pain later on,” says Dr. Stefan Schmidl.
Activity remains important in the long term as well, but must always be tailored to the individual patient. This applies not only to resuming sports after surgery but also to the type of prosthesis used — there are cemented and cementless implants. Cemented implants are immediately stable, while cementless ones must first integrate firmly into the bone. This can take several months — yet full weight-bearing is possible even in this case. Younger patients are more frequently given cementless prostheses, as the bone still has a high regenerative potential and the prosthesis can integrate well. This is no longer as effective once the bone reaches a certain age and depending on the patient’s metabolic status. It is always important to ensure the correct anchoring of the prosthesis in the appropriate bone.
“The decision is a personal one, and ultimately it is always up to the patient to decide whether to continue with their favorite sport or give it up.”
Dr. Stefan Schmidl
Chief of Endoprosthetics
“During individual follow-up consultations, we determine which sports are appropriate and when it’s safe to resume them. If someone experiences pain or swelling — even well after the surgery — these are warning signs that should be evaluated by a doctor,” explains the Chief.
An artificial joint is also a prosthetic device and can show signs of wear and tear, such as abrasion, loosening, or fractures. Therefore, weight and bone quality play an important role here.
Das Fachärzte-Team der Endoprothetik Hellersen implantiert jährlich allein 850 Knie- und Hüftprothesen. Auf der Website der Endoprothetik Hellersen erhalten Sie einen umfassenden Blick in das Zentrum für künstlichen Gelenkersatz.
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A BMI over 40 can lead to earlier loosening due to the increased stress on the joints. In some sports, forces acting on the joints can be many times the body weight, which is why this must be taken into account when choosing a sport to participate in with a joint replacement. A distinction is thus made between joint-friendly or recommended sports and those that are unsuitable or not recommended. These sports are not recommended because the risk of fractures or loosening is higher, particularly due to falls and collisions. “However, the decision is an individual one and, ultimately, always the patient’s choice whether to continue with their beloved sport or to give it up,” says Dr. Stefan Schmidl.
Recommended Sports
(Low-Impact):
- Aqua-Jogging
- Hiking
- Darts
- Golf
- Walking/Running
- Cycling
- Rowing
- Doubles tennis
- Dancing
- Nordic Walking
These sports distribute stress evenly across the prosthesis and minimize peak loads.
Sports Not Recommended
(High-Impact):
- Soccer, basketball, handball, ice hockey (Contact sports)
- Downhill skiing, snowboarding
These activities increase the risk of fractures or loosening of implants, especially in the event of falls or collisions. However, this is a personal decision and may be adjusted based on technical proficiency and willingness to accept the risk..
